DESCRIPTION (provided by investigator): The country is potentially facing a blood shortage crisis because the margin between blood collections and use has continued to decline. A significant percentage of hospitals report not being able to meet surgical and non-surgical demands. Adequacy of our blood supply is fragile since only a small number of eligible individuals actually donate blood. Fear of possible transfusion-transmitted variant Creutzfeldt Jakob disease from donors who have traveled to parts of Europe where bovine spongiform encephalitis has been identified (mad cow disease) has resulted in new stringent donor deferral criteria that are projected to disqualify 8 percent of donors. The impact will be even more severe in areas such as New York that rely heavily on imported European blood to meet patients' needs. While there has been considerable research in developing and improving laboratory tests to screen for identified viruses, little has been done to address issues of blood availability. Research on why people do not give blood is sorely lacking. Limited research has addressed motivations in current donors; but have not examined why approximately 55 percent of the population has never donated or why 45 percent donates at least once but stop. This project is designed to answer these questions. Findings will be invaluable for both formulating policy and for designing donor recruitment and retention efforts. We propose to conduct a national random digit dialing telephone survey of individuals between the ages of 18 to 65 to determine the prevalence of donating blood and to assess motivating factors, barriers, and deterrents for donating. Approximately 8000 respondents will be interviewed. The design will enable us to estimate rates for three major racial/ethnic groups, and estimate the percentage of never donors, ex-donors and current donors in each group. We will also assess blood donation attitudes, beliefs, and practices in each racial/ethnic group and make comparisons within the never-and ever-donors to identify significant differences. The survey will also provide the opportunity to objectively assess altruism and determine its importance in donating blood. Results from the survey will be invaluable in helping design effective recruitment and retention programs needed to ensure blood availability. Findings will be rapidly disseminated to the transfusion medical community and government agencies.